News and analysis:
After the Ariz. Tragedy, Mental-Health Organizations Seize a Moment

News and analysis
February 02, 2011

After the Ariz. Tragedy, Mental-Health Organizations Seize a Moment

By Maureen West

Art Foxall/UPI/Newscom
A woman looks at the makeshift memorial at the University Medical Center in Tucson, Arizona, honoring Congresswoman Gabrielle Giffords and other victims of a recent shooting.

Since last month’s shooting in Tucson, Ariz., national nonprofit mental-health organizations have begun to undertake newly aggressive steps to lobby against cuts in state budgets and to educate the public about how to spot people in need of treatment.

“All of a sudden our big issue has become one of the country’s big issues,” says Michael Fitzgerald, executive director of the National Alliance on Mental Illness, an Arlington, Va., organization that has been working for the past three decades to improve mental-health care.

The mass shooting in Tucson, Ariz.—which killed six people and wounded U.S. Rep. Gabrielle Giffords and 12 others——struck deeper and longer into American sensibilities than many people expected, mental-health officials say. Jared Lee Loughner, who was accused of the crime, showed signs of psychosis, experts say.

To be sure, more people were killed during an incident in 2007, in which 32 were murdered at Virginia Tech by a shooter with an anxiety disorder, but “the attention given to mental illness after the Tucson shooting seems greater and broader,” says James Pavle, executive director of the Treatment Advocacy Center, in Arlington, Va., whose organization advocates for more-aggressive treatment of mentally ill people who present clear risks to themselves or others.

The tragedy prompted many calls to mental-health organizations from policy makers, journalists, and the public. Traffic increased 15 percent last month over January 2010 on the National Alliance on Mental Illness’s Web site and 18 percent on Mental Health America’s, with many visitors seeking out the “how to get help” sections. And some organizations are expanding programs or starting new ones to meet the public’s education needs.

But whether mental-health charities will be able to translate this new public awareness into more financial support is tough to say, given the austere climate for government spending, say leaders of mental-health nonprofits. Thus far, the groups say, increased public interest in their cause has not translated into more private donations.

Mental health officials are careful to not characterize the mentally ill as inherently dangerous. Studies have shown that they are no more so than the general population.

Lingering Interest

Several elements of the Tucson tragedy have given the story deep relevance for the American public, say officials at mental-health groups.

For example, they say, Ms. Giffords, a personable and politically moderate public servant who was attacked while meeting her constituents, has become a survivor whose recovery many Americans are now following, which gives the story long-term interest. The death of Christina-Taylor Green, a 9-year-old girl who was attending Ms. Giffords’s “Congress on Your Corner” event, also stirred the public’s emotions, they say.

The banality of the tragedy’s setting—a supermarket on a Saturday morning—also caused it to strike a chord with many people, according to Mr. Pavle. And many of those people are aware of the role mental illness appears to have played in the shooting. Mr. Pavle notes a USA Today/Gallup poll in late January that found that 55 percent of respondents place a “great deal” of blame on the failure of the mental-health system.

Linda Rosenberg, chief executive of the National Council for Community Behavioral Healthcare, in Washington, gives President Obama credit for using his speech at a memorial for the victims in Tucson to create an atmosphere of caring.

“He took it as an opportunity to say we need to be civil to each other and to care for each other, even those who are ill, which led to big-picture and living-room discussions about mental-health issues,” she says, adding, “He said it was OK for people to seek help for someone instead of just hoping it would go away.”

A Tough Sell

But getting legislative support for mental-health programs won’t be easy, even in times when people understand the need, mental-health officials say.

The legislative season is just starting across the country, and advocates will increase their efforts to fight further cutbacks. In the aftermath of Tucson, they hope legislators will be more receptive.

Since 2009 states have cut more than $2-billion from essential mental-health services, according to the National Association of State Mental Health Program Directors Research Institute. Eighty-five percent of state mental-health agencies made cuts in services in 2009, the institute says.

Mr. Fitzgerald of the National Alliance on Mental Illness sees a possible opening now, and a stronger volunteer force to lobby state lawmakers for money. “The focus on mental health after Tucson has energized our 1,020 local affiliates,” he says.

In Arizona itself, the tragedy has not yet moved the state Legislature to approve new spending on mental-health programs. The state has reduced behavioral health services by 47 percent since 2008, a reduction of $60 million.

Eddie Sissons, executive director of the Arizona Foundation for Behavioral Health, in Phoenix, nevertheless hopes lawmakers will take a look at a report released in December by the Morrison Institute for Public Policy, an Arizona nonprofit. The report warns of trouble coming in behavioral health as a result of those cuts.

Thousands of additional mental-health patients could lose services this year, she says. Even so, she adds, the cuts this year could be less than previously expected because the shooting has made clear the dangers.

Her fight will not be easy, however: Budget-cutting conservatives in the Arizona Legislature now control both houses.

Nor will it be easier in legislatures across the county, says Steve Vetzner, a spokesman at Mental Health America, in Alexandria, Va.

Projections released in the fall from the state mental-health program directors research institute group suggest that 2011 mental-health budgets in the states will sink 8 percent or more. In 2010 spending appears to have fallen 5 percent, compared with 2009.

Mental-Health First Aid

Regardless of the outlook for government support, some mental-health nonprofit groups are using the current interest in behavioral issues to educate the public and reach mentally ill people who are not getting adequate care.

Ms. Rosenberg says her organization, the National Council for Community Behavioral Healthcare, is stepping up a campaign designed to teach ordinary people how to recognize and respond to signs of mental illness in others.

Two years ago the council started Mental Health First Aid USA and now has 12,000 people trained across the country. Because of the Tucson shooting, Ms. Rosenberg has set a goal of training 50,000 people by the end of 2011. The group is talking to Congressional offices to persuade them to get training for staff members and wants to train the D.C. Capitol Police as well.

“Many people who are quite agitated contact elected leaders and their staff,” Ms. Rosenberg says. This month the Mental Health First Aid program is in Arizona training 30 instructors to lead classes throughout the state.

“In Arizona, you had a kid”—the accused killer, Mr. Loughner—“who appeared to be actively psychotic, perhaps schizophrenic and in tremendous turmoil, and even his friends and teachers knew something was up with him,” Ms. Rosenberg says. “But there is no evidence yet that anyone tried to get him help. Mental Health First Aid, a 12-hour course, is all about helping people know the various kinds of mental illnesses and what steps can be taken to help them.”

Making Connections

Daniel Ranieri, a psychologist and president of La Frontera Center, a nonprofit mental-health clinic in Tucson, says his organization is starting a new program this month to reach out more aggressively to people who need mental-health services.

“People with mental-health problems who engage in violent behavior tend to be isolated from other people,” he says. “We need to reconnect them back into the fabric of society.”

The new mental-health program is a retooling of a suicide-prevention campaign already planned. “The same message of social connection applies to both,” Mr. Ranieri says. The campaign will include billboards, TV spots, and community meetings throughout Arizona. “Everyone is saying the shooting was a failure of the mental-health system, but the accused gunman wasn’t in the mental-health system,” Mr. Ranieri says.

Last November, Ms. Giffords filmed a four-minute spot for La Frontera to promote its programs and endorse the importance of mental-health services. La Frontera planned to make the interview part of a video this year for its community-outreach efforts but will save it for the congresswoman’s recovery.

“She sought us out and asked us to educate her, and the more she learned, the stronger advocate she became,” Mr. Ranieri says.

He hopes she recovers fast enough to be an active part of the clinic’s new campaign.